23D2076988 CLIA NUMBER - KROGER CO OF MICHIGAN, THE

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Laboratory Demographics

CLIA Number: 23D2076988

Facility Name: KROGER CO OF MICHIGAN, THE

Facility Address:
900 SOUTH U S 27 KROGER PHARMACY 018-811 ATTN PHARMACIST IN CHARGE
SAINT JOHNS, MI
ZIP 48879
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Facility Phone Number: 989 224-7075

Facility Type: Other - RETAIL PHARMACY

Certificate Type: Waiver

NPI Number: 1568496339

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	23D2076988
LAB Type	Other - RETAIL PHARMACY
Facility Name	KROGER CO OF MICHIGAN, THE
Street	900 SOUTH U S 27 KROGER PHARMACY 018-811 ATTN PHARMACIST IN CHARGE
City	SAINT JOHNS
State	MI
ZIP	48879
Phone	989 224-7075
CertificateType	4
CertificateEffectiveDate	4/30/2024
CertificateExpirationDate	4/29/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024